Periodontitis Exposure and Risk of Incident Dementia

牙周炎暴露和痴呆事件的风险

• 批准号: 8735125
• 负责人: James McCallum Noble
• 金额: $ 78.71万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-17 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8735125
• 关键词: Actinomyces naeslundii; Address; Age; Aging; Alzheimer' s Disease; Amyloid; Amyloid beta-Protein; Anti-Bacterial Agents; Antibodies; Antibody Formation; Apolipoprotein E; Atherosclerosis; Atrophic; Biological Markers; Biological Neural Networks; Blood; Blood Vessels; Brain; Cardiovascular Diseases; Cerebrum; Clinical; Clinical Markers; Cognition; Cognitive; Cognitive aging; Cohort Studies; Communities; Complex; Data; Dementia; Deterioration; Diabetes Mellitus; Diagnosis; Diffusion Magnetic Resonance Imaging; Disadvantaged; Disease; Early Intervention; Education; Elderly; Enrollment; Epidemiology; Evaluation; Functional Magnetic Resonance Imaging; Genetic; Health behavior; Height; Image; Immunoglobulin G; Impaired cognition; Individual; Inflammation; Inflammatory; Inflammatory Response; Intervention; Knowledge; Label; Language; Life Style; Magnetic Resonance Imaging; Measures; Mediating; Medical; Medical History; Memory; Minority; Modeling; National Health and Nutrition Examination Survey; Neurologic; Neurologic Examination; Neuropsychological Tests; Obesity; Oral health; Participant; Patients; Pattern; Perfusion; Periodontal Diseases; Periodontal Infection; Periodontitis; Periodontium; Persons; Plasma; Population; Porphyromonas gingivalis; Positron-Emission Tomography; Preparation; Prevalence; Public Health; Recording of previous events; Rest; Risk; Risk Factors; Role; Serum; Smoking; Stroke; Temporal Lobe; Testing; Tooth Loss; Vascular Diseases; Visuospatial; Washington; White Matter Hyperintensity; aged; base; cohort; design; innovation; insight; literacy; microbial; microorganism; neuroimaging; neuropsychological; novel; pathogen; performance tests; public health relevance; serological marker; social

DESCRIPTION (provided by applicant): Periodontitis is a bacterially induced inflammatory disorder of the tooth-supporting structures that is associated with elevated systemic inflammation. Its prevalence increases significantly with age and is particularly elevated in minority and disadvantaged populations. Limited evidence suggests that poor oral health is associated with prevalent cognitive impairment and incident dementia, but the effect of periodontitis on cognitive aging and dementia has not been examined in detail. In this proposal, we intend to formally test the hypothesis that periodontitis is an unrecognized risk factor for incident cognitive impairment among the participants in the WHICAP cohort currently being enrolled. WHICAP is a multi-ethnic longitudinal cohort of aging elderly residing in northern Manhattan. Since its inception nearly 20 years ago, more than 4,000 participants have been serially assessed in 24-month intervals with medical, social, and health behavior histories, general medical exams, and neuropsychological testing. To date, analyses of WHICAP data have markedly increased our knowledge of the complex influence of sociodemographics, genetics, health behavior and lifestyle, education, literacy, and vascular disease in the expression of incident AD and cognitive decline. In addition to these measures, current WHICAP participants are also being assessed for multiple AD biomarkers including multimodal MRI, amyloid-labeled brain positron emission tomography (amyloid-PET), and plasma amyloid. We propose to perform a detailed assessment of periodontal status using clinical, microbiological and serological markers and prospectively explore the role of periodontitis as an independent risk factor for incident AD and cognitive decline over a 4-year period. Furthermore, we will repeat the same assessments of periodontal status at 24 months after baseline, and will examine the association between the deterioration of periodontal status over the first 2-year period and incident cognitive decline over the subsequent 2-year period. We will also assess prospectively the association between microbial and serological markers of periodontitis and biomarkers of cognitive decline. Incorporating assessments of periodontal infection within the WHICAP study provides a unique opportunity to explore efficiently how periodontitis may relate to conventional measures of cognitive aging (such as neurologic and neuropsychological examinations) but also to explore sub-clinical associations among biomarkers of both diseases. Given the substantial unexplained variance in AD and dementia in the elderly population and the fact that periodontitis is both preventable and treatable, identification of periodontitis as a potential unrecognized risk factor/marker for cognitive impairment will be extremely valuable from a public health standpoint.

描述（由申请人提供）：牙周炎是细菌引起的牙齿支持结构的炎症性疾病，与全身炎症升高相关。其患病率随着年龄的增长而显着增加，在少数族裔和弱势群体中尤其升高。有限的证据表明，口腔健康状况不佳与普遍的认知障碍和痴呆症有关，但牙周炎对认知衰老和痴呆症的影响尚未得到详细研究。在本提案中，我们打算正式检验以下假设：牙周炎是目前正在入组的 WHICAP 队列参与者中发生认知障碍的一个未被识别的危险因素。 WHICAP 是居住在曼哈顿北部的老年人的多种族纵向队列。自近 20 年前推出以来，每 24 个月对 4,000 多名参与者进行了一系列评估，包括医疗、社会和健康行为史、一般体检和神经心理学测试。迄今为止，对 WHICAP 数据的分析显着增加了我们对社会人口统计学、遗传学、健康行为和生活方式、教育、识字率和血管疾病对 AD 和认知能力下降的复杂影响的认识。除了这些措施之外，目前的 WHICAP 参与者还接受了多种 AD 生物标志物的评估，包括多模式 MRI、淀粉样蛋白标记的脑部正电子发射断层扫描 (淀粉样蛋白-PET) 和血浆淀粉样蛋白。我们建议使用临床、微生物学和血清学标志物对牙周状况进行详细评估，并前瞻性地探讨牙周炎作为 4 年期间 AD 和认知能力下降的独立危险因素的作用。此外，我们将在基线后 24 个月重复对牙周状况进行相同的评估，并将检查前 2 年期间牙周状况恶化与随后 2 年期间认知能力下降事件之间的关联。我们还将前瞻性评估牙周炎的微生物和血清学标志物与认知能力下降的生物标志物之间的关联。将牙周感染评估纳入 WHICAP 研究提供了一个独特的机会，可以有效地探索牙周炎与认知衰老的常规测量（例如神经系统和神经心理学检查）之间的关系，同时也可以探索这两种疾病的生物标志物之间的亚临床关联。鉴于老年人群中 AD 和痴呆症存在大量无法解释的差异，并且牙周炎既可预防又可治疗，因此将牙周炎确定为一种治疗方法。 从公共卫生的角度来看，潜在的未被识别的认知障碍风险因素/标志将非常有价值。